Male, Age 40
During the war a sniper shot at the car he was in. The car turned over and he was thrown through the windscreen. His neck was fractured and he became quadriplegic. One year ago he had a clinical death due to spasm of his heart, lungs and diaphragm. His main fear is of death from spasm after this. His children are in the USA and he cries when he talks about them. He has mood changes and is allergic to dust, eggs and nicotine. This initial information came from a friend of his who was a student of homeopathy. The friend had given him Arnica 6c which gave him pain in the place of the original injury in his head. He also he cried. I made a home visit and his niece translated for me.
R had surgery in the USA and Sarajevo. After the 1st surgery he regained the use of his arms. Now he has no strength in his fingers (his hands hang down) and fine movements are not possible. He is in a wheelchair. The doctors in the USA found that his spinal cord was not damaged. He has some sensation and he has urinary and bowel control. His legs and fingers move involuntarily. The spasm is bad in his stomach and diaphragm; the diaphragm moves up and then he can’t breathe.
Appetite : Not big and there have been no changes in his desires or aversions since the accident.
Desires : fish, good wine and coffee.
Averse : spicey.
Aggravation from eggs++, fish, milk and butter.
Thirst ++ for beer++ and lemonade.
Constipation – one hour in the toilet.
Likes warmth ++.
Now his legs feel cold, and when they are cold it aggravates the spasm.
Perspiration only on inner arm for the last year.
Sleep position is on the right side. Before the accident he slept on his front. If he lies on his back, then he has spasm in his legs.
His job before the accident was as a technician in the local beer factory, handling beer technology and making innovations.
‘I like to think about everything, I always want to find out if I don’t know something. Now my main interest is why I can’t stand’.
He doesn’t like to be dependent, but feels safe with his wife, not with others.
Fear to stay alone in the flat – because of the spasm happening again.
He feels angry when people think there is something wrong with him mentally because he is in a wheelchair.
‘If I could walk I would first visit my mother and the place where I was born’.
He has 2 daughters aged 20 and 9. They left Sarajevo due to the war, and are now living in America. ‘I find strength in my children’.
Comments from his wife – there has been no change in his nature since the accident, he doesn’t show his feelings in front of others. The main problem is that he doesn’t accept his condition and he cares about things he can’t control. He has a big need for his family, but they are not there for him because he’s not useful to them anymore. The same with his ex-colleagues, who have rejected him.
Medication Dantrium (indicated in chronic severe spasticity of voluntary muscle) and Diazepam (muscle spasm of varied aetiology).
PMH and FMH – nothing of significance.
I observed in R that he was open, but in a way that was not showing emotion. He was clearly active in his mind and made very good eye contact. He joked throughout the consultation, despite the severity of his complaints. His general appearance was thin, long and weak looking.
Rx Cocculus 6c in 10ml bottle of water
The bottle to be succussed five times and half a capful to be taken in a little water, once a day.
This was a home visit which required an immediate prescription for practical reasons. I carried 2 travel kits containing 120 remedies, a Repertory and Materia Medica.
Analysis – Many of my questions were about what was different in R since the accident, especially regarding his general state. I was expecting to find his whole state changed as a result of such huge mental and physical trauma. Another possibility in my mind was that he would require a remedy directly related to the trauma as well as a more constitutional one.
It can be seen from the above, that in fact very little had changed in his general state and so I felt reasonably confident in choosing symptoms from this level. I took two symptoms that I was absolutely sure about, namely ‘jesting’ and ‘aggravation from eggs’ and eliminated using these.
Calc Carb 3, Carbo Veg 2, Cocculus 4, Lycopodium 2.
Following this elimination I looked at ‘paralysis’. In Murphy’s Repertory Cocculus is in bold type and Calc Carb and Lycopodium are not there at all. In Synthesis 5, Cocculus is in italics and Calc Carb and Lycopodium are plain type as an addition from Clarke’s Clinical Repertory. I also looked at ‘legs, paralysis, painless’ in which both Cocculus and Lycopodium are bold type and ‘muscles, paralysis with coldness of parts’, a small rubric which contains Cocculus. Following this I wanted to find which remedy best covered the spasm, as it is one of the most important features of R’s current state and affects his mind too. Looking in the Concordant Materia Medica I found in the first sentence under Cocculus ‘within the sphere of action of Cocculus there are many spasmodic and paretic affections, notably those affecting one half of the body…painful contracture of limbs and trunk’. Cocculus also has desire for beer and sensitivity to cold.
This case for me was an example of not having a full understanding of the totality and depth of the patient, mostly due to limitations in the information I was able to get. However, without speculating and using the few symptoms I was sure about, as well as the central physical pathology I was able to find a remedy which covered the case well. It is very interesting to me that this patient is likely to have been Cocculus before the accident as well as after. While looking at Cocculus later I found it was bold type in ‘ailments from grief’, ‘introspection’ and ‘mildness’, all of which are appropriate to this case.
First follow up, 17 days later.
‘Up to 2 hours ago I was super’.
Current symptoms are a temperature of 39.5 (up to 40 during the visit).
Cold hands ++, shivering. Red face. Head feels hot ++. No perspiration yet, lips are dry. It came very suddenly.
Since taking the remedy R reports that he has been good+++.
Less spasm all over and none in stomach. He has much more power and is now able to drive the wheelchair by himself and also get into bed from the wheelchair by himself, neither of which he could do before. This improvement in his strength happened very soon after starting the remedy.
His appetite has improved and he feels he could eat anything, except for eggs. He passes a stool now once every 2 days and without any pain. Previously it was once a week and very painful. R wakes up in a good mood, much improved from before. Something new has happened in his sleep. He is having bad dreams++, every night. Previously he was never aware of dreaming. He says he is dreaming all night with a bad feeling. He dreams of fighting with his former friends, and one dream of driving a car. He also dreamt once of walking with crutches and once without.
Overall R feels 70% better, but not close to walking. ‘I was in a good mood, I was dressing better, shaving, I felt like going out’. He has started to read newspapers and to get involved in things again. He is interested and angry about politics.
Wife says – he’s not depressed anymore, before he was. He could not sleep on one side for more than 2 hours. She used to have to turn him every 2 hours due to the spasm. His sleep is calmer and he can sleep for five hours before needing to be turned. His stool is normal. He has no problems with staying alone at night and now he’s interested in watching movies and TV. He is standing every day for half an hour in the special frame; before that it was once a week and with difficulty. He can eat and drink everything without problems.
The Cocculus was finished five days ago.
To do – if needed give Belladonna 30c.
After the fever has subsided Rx Cocculus 6c as before but with 10 succussions
Second follow up, ten days later.
R took the Belladonna and it worked immediately. After taking it there was sweating ++++. R changed his clothes 7 times in 6 hours. ‘When the fever went I felt well, as though it had never happened.’ He had pain in the bones of his legs, arms, feet, fingers and ribs after the fever.
Breathing is normal, no spasm.
Stool is normal.
Still dreaming – pilot, trip to mountain with family, driving a bus and smoking a cigarette at the same time, skiing. In all dreams he is walking. Also since the last remedy dreams every night of sex.
After he started the second bottle of Cocculus he developed a right sided pulsating headache. On the third day he experienced uncontrolled crying without knowing why, and there was no feeling with it. After crying he fell asleep.
Spasm generally feels more than after the first bottle, but it feels more on the surface. Legs are more aware of warm and cold. Generally R’s mood and strength are still much improved, though he worries about the spasm.
Rx Continue with 2nd bottle of Cocculus 6c as before. Then wait 2 weeks to see what happens, phone if gets worse in this time.
Third follow up, four weeks later.
‘It has been stormy’, R said very cheerfully.The spasms are quite strong, especially in his fingers, but also in his stomach. However, he has no problems with breathing. In the morning he feels cold, especially cold hands and from the knees down. Mornings are generally the worst time of day.
With stool there is some bleeding (piles?) – this is completely new.
For the first time since the accident he is able to feel his digestion working. He also has wind which is new. During stool, urination and bathing he has goose bumps and his hairs stand on end; this is also new. He is still dreaming but the dreams are more normal, like sitting with friends. He is able to walk in his dreams. He is dreaming of eating which is new. When lying on his back the muscles in his legs shake or tremble, which feels to be a good thing to him. His left shoulder was lower than the right since the accident, but now they are equal. ‘The stormy feeling is this feeling inside that something wants to come out of me, the feeling of everything moving inside of me, its not a bad feeling but it aggravates the spasm’.
He went out at the weekend for the first time in 6 months. He is having new thoughts which are more practical and financial, to do with planning for his wife and children’s future.
While using the remedy he felt his mood and strength steadily improving. His mood and strength have been stable since finishing the bottle twelve days ago. ‘My whole condition is better, I have more will and more wishes. If I could stand now I would be working more that I was before’.
Rx Cocculus 30c 10ml bottle, 5 succussions, 5 drops in a little water daily.
This patient’s case was taken over by a student at this point.
Comments and prognosis
I believe that Cocculus was the simillimum in this patient’s case. There was a profound change in his mental state after only a few days of 6c in water. He also experienced a real increase in his physical strength and ability to do things. His constipation, a reflection of how stuck he was, was resolved. The dreaming which started after the remedy indicated to me again how deeply the Cocculus had touched him and I believe the release of some of his physical pathology took place through these dreams as well as through the fever and sweating episode. The later active dreams told me he was taking control and moving in himself, if not on a physical level. Finally he came much more to the present by the third follow up, facing the reality of his situation and planning for the future. It is uncertain how far he will be able to improve using homeopathy. It is likely he will remain in a wheelchair, but further treatment could address more specifically the spasm and continue to maintain his positive mental state.